0036: Impact of cardiovascular risk factors management on long-term all-cause and cardiovascular mortality: an observational study

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• 作者：Emilie Berard ; ⁽¹⁾ ; ^{emilie.berard@univ-tlse3.fr" class="auth_mail" title="E-mail the corresponding author} ; Vanina Bongard⁽¹⁾ ; Dominique Arveiler⁽²⁾ ; Jean Dallongeville⁽³⁾ ; Aline Wagner⁽³⁾ ; Philippe Amouyel⁽³⁾ ; Bernadette Hass⁽³⁾ ; Dominique Cottel⁽³⁾ ; Jean Ferriè ; res⁽⁴⁾ ; Jean-Bernard Ruidavets⁽⁴⁾
• 刊名：Archives of Cardiovascular Diseases Supplements
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：8
• 期：1
• 页码：96-97
• 全文大小：62 K

文摘

In clinical trials, lowering cardiovascular risk factors (RF) reduce cardiovascular (CV) morbidity and mortality. Nonetheless, few data exist on general population.

Purpose

We assessed theimpact of the control of RF at baseline on long-term all-cause and CV mortality in French general population.

Methods

Analysis was based on the participants aged 35-64 of the Third French MONICA population-based survey on RF (1995-1996). Vital status was obtained 18 years after inclusion. Statistical analysis was based on multivariable Cox modelling. We assessed the impact of the control (according to the threshold recommended in the guidelines currently used at the time of recruitment) of high blood pressure, high LDL-cholesterol, diabetes and smoking.

Results

In our study, 3402 subjects were included. Half were men and 2.5% had history of Coronary Heart Disease. Moreover 569(17%) subjects had 2 or more non-controlled RF, 1194(35%) had 1 non-controlled RF, 770(23%) had all RF controlled under treatment (or were former smokers) and 869(25%) had none RF. During the follow-up, 389 deaths occurred (76 due to a CV cause). Considering all-cause mortality, after adjustment for centre, age, gender, educational level, proxies of alcohol consumption plus medical history of chronic disease, the hazard ratio(HR) for subjects presented 1 non-controlled RF and for subjects presented 2 or more non-controlled RF was 1.38[1.03-1.83](p=0.029) and 1.80[1.33-2.43](p<0.001), respectively, as compared to subjects presented all RF controlled. For subjects presented none RF, adjusted HR was 0.66[0.44-0.98] (p=0.042). Considering CV mortality, adjusted HR for subjects presented 1 non-controlled RF and for subjects presented 2 or more non-controlled RF was 1.70[0.84-3.42](p=0.138) and 3.67[1.85-7.29](p<0.001), respectively, as compared to subjects presented all RF controlled or none RF.

Conclusions

Failing to control RF increases significantly long-term all-cause and cardiovascular mortality.